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Chinical experience of laparoscopic spleen-preserving distal pancreatectomy
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摘要:
由于腹腔镜手术的局限性,缺乏特殊器械,以及胰腺解剖位置及结构功能的特殊性等因素,腹腔镜胰腺外科发展缓慢,仅仅用于诊断。但随着腹腔镜器械的创新,外科医生腹腔镜手术经验的增长及技术的提高,对于合适的病例,腹腔镜远端胰腺切除安全有效,为避免脾脏切除后的相关并发症,保留脾脏的远端胰腺切除更可取,而保留脾脏的方法主要有Kimura法和Warshaw法,Kimura法技术难度较大、风险高、但能保全脾功能、并发症少;Warshaw法适应证较窄,出血风险小、手术时间短,但并发症发生率高,难以保全脾功能。总之,保脾首选Kimura法,以Warshaw法作为补充。
Abstract:Due to the limitations of laparoscopic surgery,the lack of special instrument,and the particular location,structure,and function of the pancreas,laparoscopic pancreatic surgery develops slowly and is used only for diagnosis. With the innovation of laparoscopic instruments,the increases in operative experience,and the improvement in laparoscopic technology,laparoscopic distal pancreatectomy is safe and effective for the appropriate cases. In order to avoid the splenectomy- associated complications,laparoscopic spleen- preserving distal pancreatectomy is preferable. There are mainly two methods to preserve the spleen: Kimura' s method and Warshaw' s method. The Kimura' s method is a difficult technology and has a high risk,but it can preserve all functions of the spleen and has few complications. The Warshaw's method has a narrow indication,a low risk of bleeding,and a short operation time,but it has a high incidence of complications and can hardly preserve all functions of the spleen. Therefore,the Kimura' s method is the first choice to preserve the spleen and the Warshaw' s method is a replacement technology.
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Key words:
- pancreatic diseases /
- pancreatectomy /
- laparoscopy
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